2018 University of Iowa Retirees

We're proud to offer University of Iowa retirees the advantages of our Medicare Advantage plans, extras to help you get and stay healthy, outstanding customer service, and our history of industry experience to bring you the best in health care coverage.

Not a University of Iowa retiree? Check out our other plans.

Plan Details

Medical Benefits

  HMO Plus RxPPO Rx
Premium $53/mo $286/mo
Yearly Out-of-Pocket Max $4,000 $1,700 in-network
$2,000 out-of-network
Deductible $0 $0 in-network
$0 out-of-network
PCP $10 $5 in-network
40% out-of-network
Specialist $35 $5 in-network
40% out-of-network
  Find a Doctor or Hospital in this Plan Find a Doctor or Hospital in this Plan
Emergency Room $80 $50, then 10% in-network
$50, then 10% out-of-network
Urgent Care $55 $5 in-network
40% out-of-network
Inpatient Hospital $280/day (days 1–7)
$0/day (days 8+)
10% in-network
40% out-of-network
Outpatient Surgery $275 10% in-network
40% out-of-network
Ambulance $275 10% in-network
40% out-of-network
Diagnostic Tests, X-rays, Labs, and Radiology 20% 10% in-network
40% out-of-network
All Covered Preventive Services Benefit Highlights Benefit Highlights


Pharmacy Benefits

  HMO Plus RxPPO Rx
Rx Deductible
Tiers 3-5
$0 $0
Do I Have Coverage Through the Gap? Yes, 58% for generic, 45% for brand-name Yes, regular copayments apply
Tier 1:
Preferred Generic at Preferred Cost-Sharing Pharmacies, 30-day Supply
$0 $0
Tier 1:
Preferred Generic at All Other Standard Cost-Sharing Network Pharmacies, 30-day Supply
$9 $0
Tier 2:
Non-Preferred Generic, 30-day Supply
$20 30%
Tier 3:
Preferred Brand
$47 50%
Tier 4:
Non-Preferred Drug
50% 50%
Tier 5:
Speciality Tier
33% 50%
Retail 90 Benefit 90-day supply for a 2-month copay at preferred cost-sharing pharmacies and a 2.5-month copay at other network pharmacies 90-day supply for a 2-month copay at our other standard cost-sharing network pharmacies
Mail-Order 90-day supply for a 2.5-month copay with mail-order Same copayments as retail above apply to mail-order


Plan Extras

Using Your Coverage

Find a Doctor or Hospital in the HMO Plan   Find a Doctor or Hospital in the PPO Plan

  • Use your ID card whenever you see a doctor or pick up prescriptions from the pharmacy to help you and you providers access your coverage easier.
  • Your Health Alliance gives you instant access to your coverage anytime, anywhere.
  • See the HMO Plus Rx Benefit Highlight or PPO Rx Benefit Highlight for deductibles, copayments, and coinsurance info for various services.
  • The Evidence of Coverage (EOC) is your main guiding document, like a policy, for how your health care is covered on this plan:
  • You will receive a monthly bill from us, not the University of Iowa. You can choose to pay us by:
    • Credit card payment
    • Automatic deductions from your checking or savings account by filling out this form and mailing it to us
    • Withholding from your Social Security
    • Mailing your payment to us each month
  • Iowa HMO Star Ratings Flier

Pharmacies and Covered Drugs

Comprehensive Formularies

A complete list of all drugs covered by our plan:

Some covered drugs have rules or limits to when they're covered. See our Pharmacy Coverage Requirements for details.

High Risk Medications

Find high-risk medications for elderly people and alternative treatment options on this list:

Multilanguage Flier

We have free interpreter services to answer any questions you may have about our health or drug plan.

Contact Us

Already a Member

1-877-917-8550 (TTY 711)
Daily 8 a.m. to 8 p.m. local time

Voicemail used on holidays and weekends, February 15 to September 30

Email Us

Anytime Nurse Line


Mailing Address

Health Alliance
3310 Fields South Drive
Champaign, IL 61822

File an Appeal or Grievance

Learn how on our Appeals and Grievances page